妊娠期高血压疾病与阿尔茨海默病及其他痴呆症的后续风险
Hypertensive disorders of pregnancy and subsequent risk of Alzheimer's disease and other dementias.
作者信息
Schliep Karen C, Shaaban C Elizabeth, Meeks Huong, Fraser Alison, Smith Ken R, Majersik Jennifer J, Foster Norman L, Wactawski-Wende Jean, Østbye Truls, Tschanz JoAnn, Padbury James F, Sharma Surrendra, Zhang Yue, Facelli Julio C, Abdelrahman C Samir, Theilen Lauren, Varner Michael W
机构信息
Department of Family and Preventative Medicine University of Utah Salt Lake City Utah USA.
Department of Epidemiology School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA.
出版信息
Alzheimers Dement (Amst). 2023 May 21;15(2):e12443. doi: 10.1002/dad2.12443. eCollection 2023 Apr-Jun.
INTRODUCTION
Women with hypertensive disorders of pregnancy (HDP) have an increased risk of cardiovascular disease. Whether HDP is also associated with later-life dementia has not been fully explored.
METHODS
Using the Utah Population Database, we performed an 80-year retrospective cohort study of 59,668 parous women.
RESULTS
Women with, versus without, HDP, had a 1.37 higher risk of all-cause dementia (95% confidence interval [CI]: 1.26, 1.50) after adjustment for maternal age at index birth, birth year, and parity. HDP was associated with a 1.64 higher risk of vascular dementia (95% CI: 1.19, 2.26) and 1.49 higher risk of other dementia (95% CI: 1.34, 1.65) but not Alzheimer's disease dementia (adjusted hazard ratio = 1.04; 95% CI: 0.87, 1.24). Gestational hypertension and preeclampsia/eclampsia showed similar increased dementia risk. Nine mid-life cardiometabolic and mental health conditions explained 61% of HDP's effect on subsequent dementia risk.
DISCUSSION
Improved HDP and mid-life care could reduce the risk of dementia.
引言
患有妊娠高血压疾病（HDP）的女性患心血管疾病的风险增加。HDP是否也与晚年痴呆症相关尚未得到充分研究。
方法
利用犹他州人口数据库，我们对59668名经产妇进行了一项为期80年的回顾性队列研究。
结果
在对索引出生时的母亲年龄、出生年份和产次进行调整后，患有HDP的女性与未患HDP的女性相比，全因痴呆风险高1.37倍（95%置信区间[CI]：1.26，1.50）。HDP与血管性痴呆风险高1.64倍（95%CI：1.19，2.26）和其他痴呆风险高1.49倍（95%CI：1.34，1.65）相关，但与阿尔茨海默病痴呆无关（调整后的风险比=1.04；95%CI：0.87，1.24）。妊娠期高血压和子痫前期/子痫显示出类似的痴呆风险增加。九种中年心血管代谢和心理健康状况解释了HDP对后续痴呆风险影响的61%。
讨论
改善HDP和中年护理可以降低痴呆风险。
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